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年龄相关性黄斑变性与15年全因死亡率及特定病因死亡率风险

Age-related macular degeneration and risk of total and cause-specific mortality over 15 years.

作者信息

Gopinath Bamini, Liew Gerald, Burlutsky George, Mitchell Paul

机构信息

Centre for Vision Research, Department of Ophthalmology, Westmead Millennium Institute, The University of Sydney, Sydney, Australia.

Centre for Vision Research, Department of Ophthalmology, Westmead Millennium Institute, The University of Sydney, Sydney, Australia.

出版信息

Maturitas. 2016 Feb;84:63-7. doi: 10.1016/j.maturitas.2015.11.001. Epub 2015 Nov 4.

Abstract

OBJECTIVE

We aimed to investigate the independent association between AMD and risk of ischemic heart disease (IHD), stroke, and cardiovascular (CVD) mortality, and all-cause mortality over 15 years.

METHODS

3654 participants aged 49+ years at baseline were followed over 15 years. AMD was assessed from retinal photographs. Deaths and cause of death were confirmed by data linkage with the Australian National Death Index. Hazard ratios (HRs) and 95% confidence intervals (CIs) were assessed using Cox models.

RESULTS

71.4% (n=162) and 34.6% (n=1037) of participants with any AMD and no AMD, respectively, died over 15 years. After multivariable-adjustment, no significant associations were observed between AMD and total- and cause-specific mortality in the overall cohort. However, among men, late AMD at baseline was associated with an increased risk of all-cause mortality (n=22; 95.7%), 15 years later: multivariable-adjusted HR, 1.80 (95% CI 1.04-3.11). Women with late AMD had 2-fold increased risk of stroke mortality (n=15; 28.9%), HR 2.10 (95% CI 1.08-4.06). Early-stage AMD was not associated with mortality risk.

CONCLUSION

Late AMD independently predicted all-cause mortality in men and stroke mortality in women, over 15 years. Although underlying mechanisms are unclear, these findings indicate that late AMD is a marker of biological aging.

摘要

目的

我们旨在研究年龄相关性黄斑变性(AMD)与缺血性心脏病(IHD)、中风、心血管疾病(CVD)死亡率以及15年全因死亡率风险之间的独立关联。

方法

对3654名基线年龄在49岁及以上的参与者进行了15年的随访。通过视网膜照片评估AMD。通过与澳大利亚国家死亡指数的数据链接确认死亡情况和死因。使用Cox模型评估风险比(HRs)和95%置信区间(CIs)。

结果

在15年期间,患有任何AMD的参与者中有71.4%(n = 162)死亡,无AMD的参与者中有34.6%(n = 1037)死亡。经过多变量调整后,在整个队列中未观察到AMD与总死亡率和特定原因死亡率之间存在显著关联。然而,在男性中,基线时晚期AMD与15年后全因死亡率风险增加相关(n = 22;95.7%):多变量调整后的HR为1.80(95%CI 1.04 - 3.11)。患有晚期AMD的女性中风死亡率风险增加两倍(n = 15;28.9%),HR为2.10(95%CI 1.08 - 4.06)。早期AMD与死亡风险无关。

结论

在15年期间,晚期AMD独立预测男性的全因死亡率和女性的中风死亡率。尽管潜在机制尚不清楚,但这些发现表明晚期AMD是生物衰老的一个标志。

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